OVERVIEW
OVERVIEW
Respiratory bronchiolitis interstitial lung disease (RBILD) was recognized in the early 1980s. Patients are smokers or former smokers, and it was initially thought to be a disease pathologically similar to desquamative interstitial pneumonia (DIP); however, it is now believed that RBILD and DIP are manifestations of the different severity of damage to the small airways and lung parenchyma caused by cigarette smoking, i.e., two different The endpoints of the same disease are two different.
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Department
Respiratory Medicine
Clinical symptoms
Dry cough and progressive dyspnea. End-inspiratory bursting rales are audible at the lung bases.
Hazards
May cause hypoxemia, etc.
Examination
High resolution CT (HRCT), fiberoptic bronchoscopy, pulmonary function, blood gas analysis, etc.
Diagnosis
Diagnosis is based on a history of heavy smoking, typical symptoms such as dry cough and progressive dyspnea, as well as bronchoscopy, chest imaging, and lung tissue biopsy pathology.
Treatment principle
Smoking cessation, anti-inflammatory and other treatments.
Curability
The efficacy is good, and some patients can have partial or complete remission without any treatment.
Dietary advice
Pay attention to balanced nutrition and avoid spicy and greasy food, etc.
Important Reminder
Smoking patients should quit smoking immediately to facilitate the recovery of the disease.
Causes
Epidemiology
RBILD is mainly found in people who smoke a lot and are exposed to substances. It affects both men and women, with a predominance of middle-aged and elderly people.
Etiology
May be a nonspecific cellular response to heavy smoking and exposure.
Symptoms and Diagnosis
Typical symptoms
Dry cough and progressive dyspnea are the main symptoms. Some patients cough up a small amount of mucous sputum, and end-inspiratory bursting rales can be heard at the lung bases.
Other symptoms
Other symptoms include chest pain, fatigue and weight loss.
Diagnostic basis
The patient has a history of heavy smoking and presents with a dry cough and progressive dyspnea with end-inspiratory rales audible at the lung bases. A large number of brown macrophages were seen in the bronchoalveolar lavage fluid (BALF), and HRCT of the lungs showed wall thickening of the central and peripheral bronchioles in a diffuse distribution, centrally located nodular shadows in the lobules, or diffuse ground-glass shadows, with the exception of other diseases, which required lung biopsy pathology to confirm the diagnosis.
Treatment
Treatment guidelines
Smoking cessation is the mainstay; patients’ clinical symptoms and lung function will improve after smoking cessation. The treatment is effective.
Medication
Prednisone acetate is commonly used.
Prognosis
The prognosis is good.
Nursing care
Daily care
Pay attention to rest, avoid cold and exertion, avoid or reduce dust and smoke inhalation, avoid active and, to prevent and timely treatment, etc.
Dietary conditioning
Pay attention to nutritional balance, avoid eating spicy and greasy food, etc.